Composite platysmaplasty and closed percutaneous platysma. Role of platysma muscle flap in depressed scars of neck core. The outline of the platysma flap is initially made. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection.
My ps recommends a submental lipectomy with plicatio of platysma for my neck waddle. Maxillofacial reconstruction following the excision of. Twenty patients were treated for intraoral epidermoid carcinoma with a singlestage reconstructive technique using a myocutaneous flap based on the platysma. Methods total 65 patients were included in this study from march 2005 to december 2012.
Deepithelialized transverse platysma flap iranian journal of otorhinolaryngology, vol. The results of treatment of 36 patients tumour excision plus bilateral neck dissection and post. Jul 24, 20 platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. Twenty patients were treated for intraoral epidermoid carcinoma with a singlestage reconstructive technique using a myocutaneous flap based on the pl. Sureflap microchip cat flap user manual pdf download. In 2 patients with advanced cervical esophageal cancer invading the trachea, total laryngoesophagectomy with resection of the posterior portion of the trachea and lymph node dissection of the bilateral neck and superior mediastinum was carried out. Pdf platysma myocutaneous flap its current role in reconstructive. The platysma myocutaneous flap pmf for head and neck reconstruction. The posteriorly based platysma flap is a reliable reconstruction option for defects in the facial and oral region. The platysma myocutaneous flap has seen limited application in the reconstruction of head and neck defects over the past decade.
Platysma myocutaneous flap for oral cavity reconstruction. Submental versus platysma flap for the reconstruction of. Typically, muscles in the body lie deep to the skin and layers of subcutaneous tissue, otherwise known as the superficial fascia. The inferiorly and laterally based platysma myocutaneous flap contains. Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects.
These patients received surgical reconstruction of platysma flap and submental flap at the department of. However, there seems to be a role for regional or local flaps. Platysma myocutaneous flap its current role in reconstructive. Damage to the great auricular nerve, with consequent clinical deficits, is a common surgical complication in facial aesthetic and in head and neck procedures such as parotidectomy, neck dissection, rhytidectomy and platysma flap operations. Primary features of the technique are horizontal cuts in the vertical bands of the platysma muscle combined with a corset zplasty medial suture and bilateral rein plication suture. These nerves enter the platysma muscle and overlying skin laterally, a flap raised in the way described above preserves the sensory supply of the skin transposed to the facial region fig. This study demonstrates that both platysma and submental flap techniques can be used for the reconstruction of complex facial defects with the acceptable functional outcome. Platysma musculocutaneous flap for reconstruction of trachea. The posteriorly based platysma flap in oral and facial reconstruction.
Despite these advantages, flap harvest requires resection of platysma, which may cause a marginal mandibular nerve pseudo. Infraoperative elevation of the superior cervical skin and myocutaneous platysma flap prior to neck dis section. The platysma myocutaneous flap was introduced for intraoral reconstruction in 1978. Platysma muscle additionally innervated by a variant anterior. View and download sureflap microchip cat flap user manual online. The aim of the study is to present our experience using vertical pmf that. Platysma muscle flap has a definitive role in revision surgery of depressed scars in neck as it provides an ideal tissue for lost tissue volume. Pectoralis major myocutaneous flap for head and neck. Objectives the use, advantages, and disadvantages of the platysma flap were assessed.
The platysma myocutaneous flap dates back to 1887 when an austrian surgeon, robert gersuny, described repair of a cheek defect. However, the platysma flap remains an alternative for reconstruction of the oral cavity because it is versatile, portable, and thin. Atlas of muscle and musculocutaneous flaps globalhelp publication. The advantages of platysma flap include good color match, easy access to the donor site in the same operative field with minimum morbidity of donor site, ease. Department of craniomaxillofacial surgery, faculty of dentistry, hannover medical university, hannover, germany. Vertical platysma myocutaneous flap reconstruction for t2staged oral carcinoma. A permanent tracheostoma, composed of the tracheal remnant. Complete neoglottic closure and acceptable voice quality were obtained by platysma myofascial flap in all cases. Vocal function was assessed by videolaryngostroboscopy and subjective and objective voice analysis before and after surgery. Platysma muscle additionally innervated by a variant. The platysma flap may be used to close defects on the lower face, buccal mucosa, and floor of mouth.
The platysma is considered to be one of the muscles of facial expression because of its association with the skin of the face and neck, and because it will join to muscles that surround the mouth. Platysma myocutaneous flap is easy to harvest, thin and pliable, promoting threedimensional reconstruction, and there is a limited donor site morbidity with primary closure of the neck. The platysma myocutaneous flap oral and maxillofacial surgery. It is a versatile, portable, and thin flap, is easy to perform, and can be obtained during neck dissection, with a primary closure of the donor site. There are anatomical and physiological reasons for this. Because of its association with the skin, changes in the muscle and skin tension can. The procedure was done under local anesthetic in two patients. The platysma myocutaneous flap has been used with promising results for the reconstruction of intraoral post ablative defects. Slaughter fitzhugh, md, charlottesville, virginia successful performance of the various types of ab lative and reconstructive head and.
Turnover platysma flaps also correct such a deformity. The platysma musculocutaneous flap has been used in 24 patients for reconstruction in the head and neck area. Twenty patients were treated for intraoral epidermoid carcinoma with a single stage reconstructive technique using a myocutaneous flap based on the platysma. With the forceps pulled firmly, the first anchoring suture was made. The outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle. If a standard aprontype flap is raised for a neck dissection, the inferior margin of that flap will be the inferior margin of the platysma flap. William futrell, md, charlottesville, virginia michael e. The mean reduction in mouth opening was significantly smaller in platysma group 0. Open access guest editorial kummoona platysma muscle flap. Yet, it was only introduced to the english literature in 1978 by futrell et al, 1 and since then, it has become established as an attractive reconstructive alternative with several potential advantages. It includes the delicate superficial cervical fascia just deep to skin that envelopes the platysma and muscles of.
The use of myocutaneous flaps has resulted in improved methods for reconstruction involving the head and neck area. The superiorly based flap has an excellent blood supply, but less efficient venous drainage when compared with posteriorly based flap. Platysma myocutaneous flap for intraoral reconstruction. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands in oral submucous fibrosis. Platysma myocutaneous flap for intraoral reconstruction, am. Biologic basis of deepithelialized transverse platysma flap. Small to mediumsize defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The platysmal myocutaneous flap has shown promising results for the reconstruction of defects in the head and neck region. Reconstruction of the oral cavity using the platysma. The posteriorly and the superiorly based platysmal flaps. A retrospective and multicentric analysis of 91 t1t2 patients. The aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction. The posterosuperiorly based platysmal myocutaneous flap. The platysma myocutaneous flap for oral cavity reconstruction.
Vertical platysma myocutaneous flap that sacrifices the facial artery. In selected patients, the platysma myocutaneous flap is a highly useful onestage procedure to close defects of the oral cavity. Since the first report of a platysma transverse myocutaneous flap in 1977, few articles about this flap design have been added to the literature. Pdf utility of superiorly based platysma myocutaneous. A wide cervical flap was then raised, and anatomic dissection of the superficial and deep venous systems was performed to identify the dominant draining veins of the platysma flap. In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is a viable option. The outline of the platysma flap is initially made as an. The length of followup ranged from 4 months to 10 years with an average of 5 years. The platysma myocutaneous flap offers an excellent alternative for reconstructing appropriate oral cavity defects resulting from tumor ablation. Twenty patients were treated for intraoral epidermoid carcinoma with a singlestage reconstructive technique using a myocutaneous flap based on the platysma muscle. Its flap may be used as superiorly, inferiorly or posteriorly based. The platysma flap has often been used for reconstructions of the head and neck, but the arterial anatomy of the platysma itself has not been clarified. The partial defect in the trachea was repaired with a platysma musculocutaneous flap.
The advantages of this flap are the proximity to the surgical area, and the fact that the skin island pedicled by platysma muscle is easily harvested and transplanted to the defect. Venous drainage of the platysma myocutaneous flap anurag. This article presents two versions of the platysma myocutaneous flap. The platysma myocutaneous flap, operative techniques in. In selected cases, the flap will extend to the oropharynx. The platysma flap is a good method to reconstruct small and medium sized defects of oral. Platysma myocutaneous flap for patch stricturoplasty in relieving short and benign cervical esophageal stricture yidan lin, md, yaoguang jiang, md, ruwen wang, md, taiqian gong, md, and jinghai zhou, md thoracic surgery department, daping hospital, third military medical university, chongqing city, china. Health, general cell research cytological research face lifts health aspects patient outcomes research flaps surgery medical research medicine, experimental mouth diseases care and treatment rhytidoplasty surgical flaps. Research open access vertical platysma myocutaneous. Platysma myocutaneous flap for reconstruction of intraoral.
The platysma flap is a good method to reconstruct small. Platysma myocutaneous flap for intraoral reconstruction j. Pdf utility of superiorly based platysma myocutaneous flap. The muscle was taken with the forceps at the spot where the cervicomandibular angle was to be placed figure 3, a and b. Meticulous anatomic dissection of the vasculature of the superficial anterolateral neck indicates that the platysma and overlying skin are supplied by direct cutaneous arteries measuring 0. Feb 21, 20 the outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle. Angiographic study of the platysma, abstract background. Original article, report by ear, nose and throat journal.
Platysma myocutaneous flap for patch stricturoplasty in. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects. Download the free realself iphone app for faster and easier browsing get the realself iphone app. Platysma myocutaneous flap for reconstruction of skin defects in the. Health, general cell research cytological research face lifts health aspects patient outcomes research flaps surgery medical research medicine, experimental mouth diseases care and treatment. Platysma myocutaneous flap is a flap of the skin and muscle, raised from the lower neck, based on.
Biologic basis of deepithelialized transverse platysma. My ps recommends a submental lipectomy with plicatio of. Platysma myocutaneous flap for intraoral defects jama. The plane of elevation should include the sternocleidomastoid fascia, as. Laryngeal reconstruction by platysma myofascial flap after. Before flap harvesting the anticipated intraoral defect is measured. This tissue is a very superficial layer of fatty connective tissue. Managing platysma bands in the aging neck aesthetic surgery. Nineteen of 22 patients in whom this flap was used healed without major complication. This flap is raised as a skin platysma flap at the caudal part, so neck structures can be exposed for neck dissection if indicated. This combined procedure, which effectively lifts the sagging neck, is useful in treating vertical platysma bands in primary cases, as well as recurrent platysma bands. Microchip cat flap pet care product pdf manual download. Aug 11, 2005 the surgical procedure and flap design were described.
The platysma myocutaneous flap for oral cavity reconstruction kevin h. The platysma myocutaneous flap pmf is a common reconstructive option for defects in the head and neck region. Five cases are presented, three men and two women, 51 and 71. Vertical platysma myocutaneous flap that sacrifices the. Role of platysma muscle flap in depressed scars of neck rakesh k. Latysm anatomical considerations surface markings adjacent muscles vascular pattern motor nerve. Managing platysma bands in the aging neck aesthetic. The platysma myocutaneous flap for intraoral reconstruction was introduced in 1978. The platysma myocutaneous flap has enjoyed limited popularity despite its versatility, dependability, and ease of harvesting. A platysma myocutaneous flap for intraoral reconstruction is outlined and the surgical technique described.
Research open access vertical platysma myocutaneous flap that sacrifices the facial artery and vein zhenning li1,2, ruiwu li1,2, fayu liu1,2, qigen fang1,2, xu zhang1,2 and changfu sun1,2 abstract background. Pdf vertical platysma myocutaneous flap reconstruction for. Hence, a thorough knowledge of nerve anatomy, particularly its potential variations, is critical in reducing the associated operative. It has been successfully used for the reconstruction of the defects over the cheek, floor of the mouth, buccal mucosa, tongue, lower lip, mandibular alveolus, hypopharnx and supraglotic larynx. Including the platysma muscle in a cervicofacial skin. Request pdf biologic basis of deepithelialized transverse platysma flap for oral cavity reconstruction introduction. The platysma muscle lies within the subcutaneous tissue in the anterolateral neck.
Role of platysma muscle flap in depressed scars of neck. Same patient as in figures 4 and 5 one year after platysma myocutaneous flap. A pedicled platysma myocutaneous flap is dissected c and rotated. Universally, small communicating veins from the internal jugular venous system were noted to drain the platysma flap anteriorly. In this article, we describe 12 consecutive patients who underwent platysma flap reconstruction of various oral cavity and oropharyngeal defects. Pdf vertical platysma myocutaneous flap reconstruction.
Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an. The composite flap was pulled by the surgeon using a kocher or allis clamp, taking the anterior border of the incised platysma attached on the flap. This anatomic study supports the vascular viability of the platysma flap in 2 different designs for oral and maxillofacial reconstruction. Due to its consistent vascular and lymphatic anatomy, the vascularized submental lymph node flap is a reliable option for lymphedema treatment. The diverse indications described for the platysma. Most authors who described the technique used a superiorly based flap, elevated the skin flap to fully expose the platysma, and ensured a minimum muscle. Open access guest editorial kummoona platysma muscle. Platysma myocutaneous flap revisited jama otolaryngology. Instead, it runs just below the epidermis and dermis in the superficial layer of fascia in the cervical region. The platysma flap was described in 1970 by paul tessier, but was immediately eclipsed by other techniques such as the myocutaneous pectoralis flap or the microsurgical temporary flap 57.
Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects 5 skin paddle up to the mandible, leaving the platysma down. The objective of this paper is to show that platysma flaps have good results and should be an alternative in reconstructive surgery for oral tumors when microsurgery is not possible. Pdf the platysma myocutaneous flap pmf for head and. It is a random flap comprising skin, subcutaneous fat, superficial neck veins, and platysma muscle. There has been an emphasis on the anatomical vascular supply and method of preparation of the platysma.
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